Improvements Needed for Maternity Care - Minister Harney

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AIMSire Posts: 63
AIMS Ireland attended a meeting with Mary Harney, minister for Health on Friday 14th December. The issues discussed at this meeting concerned 4 main issues. 1. The publication of Annual Clinical Reports and Maternity Hospital Statistics. In order to capture nationally and uniformly the rates of intervention and outcomes across all hospitals. We feel this is vital, in order for women to make informed choices when choosing a hospital and in order to allow monitoring of hospital procedures. This allows easy comparison with international best practice and would also pick up on serious deviations from the norm, as with the Dr. Michael Neary case. 2. The creation of National Guidelines for Clinical Practice in Maternity Care. These guidelines need to reflect international best practice such as that published by the National Institute of Clinical Excellence (NICE), the Royal College of Midwives (RCM), the Royal College of Obstetricians and Gynaecologists (RCOG) and the World Health Organisation. It is unacceptable for practices in Irish Maternity Hospitals to deviate for that which is regard as best international best practice. 3. A National Independent Consultative / Auditing Body to oversee the writing and implementation f the National Guidelines. This body would monitor and compare stats from all hospitals and investigate discrepancies in these figures. They would then take appropriate action, where necessary. They would also deal with complaints from consumers and health professionals in a clear, structured and independent manner. It is vital that this body would have representation from all stakeholders, including healthcare professionals and consumers 4. Changing the Health Amendment Act 1991 to allow women who choose Midwifery Led care to access private beds on an equal footing to those who choose Obstetrician Led care on a private basis. Currently legalisation on this issue prevents women from choosing the health care provider which is the most appropriate care giver to the majority of pregnant women, according to the World Health Organisation. If you agree with the above Maternity Care Monitoring Structures, please write to the Minister for Health Ms. Mary Harney, or your local representative, to ask for these changes to be implemented. If you want more information about AIMS Ireland, please visit http://www.aimsireland.com Happy Christmas Everyone!! Breda Kerans AIMS Ireland
Avril Hiswife Posts: 1743
This is interesting. Does anyone else think it strange that so many births in Ireland seem to involve lots of medical intervention compared to the UK or Australia? And the way women on this forum who were miscarrying have sometimes been treated is a disgrace >:o(
babe06 Posts: 898
Definitely agree about the intervention but I think thats because the number of c-sections is so low and we're left to go longer with bigger babies. In other countries women are brought in early and more sections are performed if necessary. I really think they try to keep sections to a minimum here due to statistics which is a disgrace
Avril Hiswife Posts: 1743
interesting point, Babe06 I've heard that planned (elective) sections are much safer than emergency ones...
molls Posts: 149
[quote="babe06":1kgcehu3]Definitely agree about the intervention but I think thats because the number of c-sections is so low and we're left to go longer with bigger babies. In other countries women are brought in early and more sections are performed if necessary. I really think they try to keep sections to a minimum here due to statistics which is a disgrace[/quote:1kgcehu3] You think a 25% section rate is LOW! and that we should have more?
AIMSire Posts: 63
Dear All, Just some background information for anyone unfamiliar with Maternity Best Practice and current rates. The recommendation rate for cesarean section with the World Health Organisation and Unicef is 10% - to which they extended to a sliding scale of between 10-15%. This means that all maternity units worldwide should strive for a cesarean rate of around or under 15% and the VBAC rate should be at least 70% Irish Cesarean rates vary but would exceed the recommendation substantially and would be only slightly lower to the rate in The United States. There are many Countries with significantly lower cesarean rates than Ireland despite similar characteristics/demographics - including birth weights, genetic makeup, etc. The Cuidiu Guide and Resource holds all the statistics and information from 2005 data and may be of interest : Cuidiú-Irish Childbirth Trust - Consumer Guide to the Maternity Services in Ireland. http://www.cuidiu-ict.ie/fulcrum.html?ep=13 for Guide information http://www.cuidiu-ict.ie/fulcrum.html?ep=54 for nationwide comparison tables of birth statistics http://www.cuidiu-ict.ie/fulcrum.html?ep=53 for info on each individual unit. Happy Christmas! Jene Kelly AIMS Ireland edited to add the links for Cuidiu
Avril Hiswife Posts: 1743
Is it that they are performing unnecessary sections or that there is something about antenatal care that makes more sections necessary? Like maybe, expectant mothers here are given less continuity of care and are more stressed as a result?
AIMSire Posts: 63
Hi, Continuity of Carer is a huge issue and something that AIMS Ireland are really focusing on due to our own experiences and the feedback we have had from women and from our surveys. Many many Irish women simply aren't getting support in labour - this needs to change. Cesarean rates can vary for many reasons - many countries have 'elective' cesareans which is not an option in Ireland The research suggests that routine interventions (when something is done without medical necessity but simply to speed things along) and induction (to start labour medically) as a link to high cesarean rate - often described as a cascade of intervention. This means that one intervention can often lead to another and eventually mum or baby may not tolerate the labour in the same way a labour left to progress on its own would. This is why the World Health Organisation has put the rate at 10-15% - they have researched and found that 85-90% of women do not fall into the catagory of medically needing a cesarean section. Hope that Helps!
molls Posts: 149
Aimsire, it's c[b:1dvql9ci]a[/b:1dvql9ci]esarean.
Toblerone Posts: 2698
[quote="molls":3g3cvlvw]Aimsire, it's c[b:3g3cvlvw]a[/b:3g3cvlvw]esarean.[/quote:3g3cvlvw] Cesarean is US spelling like labor/esophagus etc. Still correct. Check out [url:3g3cvlvw]http://scholar.google.com/scholar?q=cesarean&hl=en&lr=[/url:3g3cvlvw] All very distinguished scholarly papers and no-one picked them up on the spelling. Better to focus on the content rather than spelling. Scary that the WHO recommends 10-15% and Ireland is 25%. :wv